弥散张量成像(DTI)在胶质瘤分级中的应用价值初探

Preliminary study of diffusion tensor MR imaging in grading cerebral gliomas

目的初步探讨弥散张量成像(DTI)在胶质瘤分级中的应用价值。方法收集经手术病理证实的高级别胶质瘤13例和低级别胶质瘤8例,均作了MRI平扫、增强扫描和DTI,测定两组肿瘤实质区、囊变坏死区及瘤周水肿区MD值、FA值,分别比较两组肿瘤上述三个区域有无统计学差异。结果高级别组肿瘤实质区、囊变坏死区及瘤周水肿区MD值分别为(0.976±0.171)×10-9㎜2/s、(1.92±0.515)×10-9㎜2/s、(1.41±0.288)×-9㎜2/s,低级别组上述三个区域MD值分别为(1.28±0.320)×-9㎜2/s、(1.77±0.567)×-9㎜2/s、(1.19±0.218)×-9㎜2/s,高级别组肿瘤实质区MD值低于低级别组(P<0.05),两组肿瘤囊变坏死区、瘤周水肿区MD值无统计学差异(P>0.05);高级别组上述三个区域FA值分别为0.137±0.056、0.0824±0.061、0.148±0.09,低级别组分别为0.149±0.0504、0.105±0.0623、0.160±0.083,两组肿瘤上述三个区域比较均无统计学差异(P>0.05)。结论通过测定胶质瘤肿瘤实质区MD值,有助于胶质瘤的分级。

Objective To investigate the value of diffusion tensor MR imaging in grading cerebral gliomas. Methods Thirteen patients with high-grade gliomas and eight patients with low-grade ones proved by surgico- pathology underwent MRI plain and contrastenhanced scanning and diffusion tensor MR imaging.Mean diffusivity（MD） and fractional anisotropy（FA） values were measured in solid tumor, cystic or necrotic and surrounding edema regions. Differences in these values between two groups were assessed. Results The difference with MD was found in solid tumor components between high-grade group （（ 0.976 ± 0.171）, 10^-9mm^2/s） and low-grade one（（1.28 ± 0.320） × 10^-9mm^2/s）（p 〈 0.05）. There weren ＇ t any differences with MD in cystic or necrotic and surrounding edema regions between high-grade group（ （ 1.92 ± 0.515） × 10^-9mm^2/s, （ 1.41 ± 0.288）× 10^- 9mm^2/s） and low-grade one（（1.77 ± 0.567） × 10^-9mm^2/s, （ 1.19 ± 0.218） × 10^-9mm^2/s, respectively）（P 〉 0.05）. There weren ＇ t any differences with FA in solid tumor components,cystic or necrotic,and peritumoral region between high-grade group（0.137 ±0.056,0.0824 ± 0.061,0.148 ± 0.09） and low-grade one（0.149 ± 0.0504,0.105 ± 0.0623, 0.160 ± 0.083,respectively）（P 〉 0.05）. Conclusion The value of MD with solid tumor components can be used to help grading cerebral gliomas.